The process of raising healthy eaters actually starts before conception. The health of women entering –and during – pregnancy has a profound impact on the health of both mom and baby.

Part of my job is to inform you (my readers) of important changes in public health recommendations. The Institute of Medicine last tackled pregnancy and weight in 1990 – almost 20 years ago. Health experts have been talking about the need to re-examine these guidelines for the last several years. Yet the newly released guidelines from the Institute of Medicine don’t look much different from the 1990 ones. That said, a lot was learned in the process. Let’s take a look…

A Different Population of Women
Pregnant women today look drastically different than moms-to-be did just 20 years ago. First off, more women start pregnancy either overweight or obese and they gain more weight during pregnancy. Women are also having children later in life with a substantial increase in multiple births. All of these factors increase the likelihood of chronic disease and complications during and after the prenatal period.

Key Takeaways
The Institute of Medicine extensively reviewed studies to determine the optimal range of weight gain for pregnant women. Here are some highlights from the report:
–Weight at the start of pregnancy may be the most important factor for a healthy pregnancy. The science clearly shows that pre-pregnancy weight alone can predict undesirable prenatal health outcomes.
–Women who gain more than the recommended amount of weight during pregnancy are more likely to have c-sections, preeclampsia, gestational diabetes and they are likely to remain overweight long after birth.
–Women who start off pregnancy underweight and gain less than the recommended amount of weight tend to have small (for gestational age) babies. Women who gain more than the recommended amount of weight tend to have large (for gestational age) babies.
–Gaining too little or too much weight has also been associated with preterm birth.

The Guidelines
Below are the 2009 guidelines from the Institute of Medicine. The guidelines assume that women gain 1.1-4.4 pounds in the first trimester. The biggest change from 1990 is the smaller range of weight gain for obese women:

Underweight <18.5 (28-40 pounds)
Normal Weight 18.5-24.9 (25-35 pounds)
Overweight 25.0-29.9 (15-25 pounds)
Obese > 30 (11-20 pounds)

Provisional guidelines for twins: normal weight (37-54 pounds), overweight (31-50 pounds), obese (25-42 pounds).

Want to know your BMI. Check it out here.

To Sum Up
Beginning pregnancy at a healthy weight and gaining a sensible amount during the pregnancy provides a healthier start for both you and your baby. This is an incredible opportunity because it allows you to develop a healthier relationship with food before your child is even born.

For more information on nutrition and pregnancy see our pregnancy nutrition section.

Subscribe to Raise Healthy Eaters to learn more about nutrition during pregnancy.

References
Weight Gain During Pregnancy: Reexamining the Guidelines